Materi :________________________
Judul :________________________
Guru :________________________
Tanda Tangan
(_______________________)
Jam Ke Tiga
Materi :________________________
Judul :________________________
Guru :________________________
Tanda Tangan
(_______________________)
Jam Ke Empat
Materi :________________________
Judul :________________________
Guru :________________________
Tanda Tangan
(_______________________)
Jam Ke Lima
Materi :________________________
Judul :________________________
Guru :________________________
Catatan................................................................................................................... Tanda Tangan
.................................................................................................................................
.................................................................................................................................
................................................................................................................................. (_______________________)
................................................................................................................................. Wali Kelas
Keterangan : Hadir ( . ), Sakit ( S ), Izin ( I ), Tugas ( T ), Alfa ( A )
Jumlah Santri : ________
Susi Susanti, S.Pd